Glucose-Lowering Drugs and Fracture Risk-a Systematic Review

Z Al-Mashhadi, R Viggers, R Fuglsang-Nielsen, F de Vries, J P van den Bergh, T Harsløf, B Langdahl, S Gregersen, Jakob Starup-Linde*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

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Abstract

PURPOSE OF REVIEW: Diabetes mellitus (DM) is associated with increased fracture risk. The aim of this systematic review was to examine the effects of different classes of glucose-lowering drugs on fracture risk in patients with type 2 DM. The heterogeneity of the included studies did not allow formal statistical analyses.

RECENT FINDINGS: Sixty studies were included in the review. Metformin, dipeptidylpeptidase-IV inhibitors, glucagon-like peptide-1 receptor agonists, and sodium-glucose cotransporter 2-inhibitors do not appear to increase fracture risk. Results for insulin and sulphonylureas were more disparate, although there may be an increased fracture risk related to hypoglycemia and falls with these treatments. Glitazones were consistently associated with increased fracture risk in women, although the evidence was sparser in men. New glucose-lowering drugs are continuously being developed and better understanding of these is leading to changes in prescription patterns. Our findings warrant continued research on the effects of glucose-lowering drugs on fracture risk, elucidating the class-specific effects of these drugs.

Original languageEnglish
Pages (from-to)737-758
Number of pages22
JournalCurrent Osteoporosis Reports
Volume18
Issue number6
DOIs
Publication statusPublished - Dec 2020

Keywords

  • Type 2 diabetes
  • Fracture
  • Glucose-lowering drugs
  • Antidiabetics
  • Glitazones
  • Insulin
  • Systematic review
  • PEPTIDE-1 RECEPTOR AGONISTS
  • DIPEPTIDYL PEPTIDASE-4 INHIBITORS
  • TYPE-2 DIABETES-MELLITUS
  • BONE-MINERAL DENSITY
  • LONG-TERM USE
  • HIP-FRACTURES
  • IN-VIVO
  • CARDIOVASCULAR OUTCOMES
  • OSTEOPOROTIC FRACTURES
  • POSTMENOPAUSAL WOMEN

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